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St. Aloysius Gonzaga is a young Jesuit who selflessly gave his life caring for victims of the deadly plague in Rome
in 1591. Blessed Anuarite Nengapeta is a young Sister of the Holy Family d’Isiro-Wamba and a midwife who was murdered resisting the sexual advances of a rebel leader in the Congo in 1964. We entrust
the African Jesuit AIDS Network to their prayer and protection.

UN World Population Projection: The 2002 REVISION and the Impact on AIDS

From the 60s until the early 90s, demographers predicted a world population of over 10 billion in the year 2050 with expressions like
“population explosion” and worries about the earth’s “carrying capacity.” During the late 90s a lowering of fertility was noticed, however, not only in developed countries but also in developing ones
which had earlier shown no signs of major fertility reduction.

Note that population projections are estimates based on
assumptions of existing data. They are like the estimates that a driver makes, based on the speedometer, regarding how long it will take to reach the destination, and as present conditions change (more
traffic, bad weather), the estimated time of arrival gets revised. Similarly, depending on the current data, the UN reports present high, medium and low variants of projections.

On 26 February 2003, the U.N. Population Division released its WORLD POPULATION PROSPECTS: THE 2002 REVISION. This document “breaks new
ground” first in terms of the assumptions made on future human fertility and secondly because “it anticipates a more serious and prolonged impact of the HIV/AIDS epidemic in the most affected countries
than previous revisions.”

As a consequence of these changes, the 2002 REVISION projects a lower population in 2050 than the
2000 REVISION: 8.9 billion instead of 9.3 billion according to the medium variant. About half of the 0.4 billion difference results from an increase in the number of projected deaths, the majority
stemming from higher projected levels of HIV prevalence. The other half of the difference reflects a reduction in the projected number of births, primarily as a result of lower expected future fertility
levels.

Growth Rates: The basic components needed to project the rate at which world population grows are annual fertility
and mortality rates (the number of births or deaths in a particular year per thousand persons in the population). The difference between these rates indicates the growth rate at any specific period.
“Whereas today the population of the more developed regions of the world is rising at an annual rate of 0.25 per cent, that of the less developed regions is increasing nearly six times as fast, at 1.46
per cent,” and “the 49 least developed countries is experiencing even more rapid population growth (2.4 per cent per year).”.


Fertility Levels: An intuitive way of considering fertility is to consider the number of children a woman can bear during her life cycle. If she has 2.1 children the population is termed to
be at replacement level. If fertility falls below this level, the population will shrink in size. For most of the developed countries fertility levels are expected to remain below replacement level during
2000-2050. The populations of 33 countries are projected to be smaller by mid-century than today (e.g., 14 per cent smaller in Japan and 22 per cent smaller in Italy).

The fertility of less developed countries is projected to decline markedly in the future (from 5.1 children per woman today to 2.5 children
per woman in 2045-2050). However, with sustained annual growth rates higher than 2.5 per cent between 2000 and 2050, the populations of Burkina Faso, Mali, Niger, Somalia, Uganda and Yemen are projected
to quadruple, passing from 85 million to 369 million in total.

World Population Size: As a result of these trends, the
population of the world is now estimated to be 8.9 billion in the year 2050. Population size of more developed regions, currently at 1.2 billion, is anticipated to change little during the next 50 years
The population of the less developed regions is projected to rise steadily from 4.9 billion in 2000 to 7.7 billion in 2050 (medium variant). Particularly rapid growth is expected among the least developed
countries whose population is projected to rise from 668 million to 1.7 billion.

Large population increments are expected
among the most populous countries even if their fertility levels are projected to be low. Thus, during 2000-2050, eight countries (India, Pakistan, Nigeria, the United States of America, China,
Bangladesh, Ethiopia and the Democratic Republic of Congo, in order of population increment) are expected to account for half of the world’s projected population increase of around 1.5 billion.

Mortality and Impact of AIDS: Besides the use of death rates, an intuitive understanding of the mortality level of a country is
provided by considering the “life expectancy at birth,” i.e. the number of years a new-born child is expected to live — given the existing health and other environmental conditions of the country.
Projection models usually indicated a steady increase in expectation of life under the assumption that, with the increasing availability of preventive health measures, particularly immunisation of
children, mortality levels would fall.

In fact the UN report indicates the increasing diversity of future mortality levels.
At the world level, life expectancy at birth is likely to rise from 65 years today to 74 years in 2045-2050. But whereas more developed regions, whose life expectancy today is estimated at 76 years, will
see it rise to 82 years, that of less developed regions will remain considerably below, reaching 73 years by mid-century (up from 63 years today).

In the group of least developed countries, many of which are highly affected by the HIV/AIDS epidemic, life expectancy today is still below
50 years and is not expected to exceed 67 years by 2050. So, although the gap in life expectancy between the different groups of countries is expected to narrow, major differences in the probabilities of
survival will remain evident by mid-century.

The 2002 REVISION indicates a worsening of the impact of the HIV/AIDS epidemic
in terms of increased morbidity, mortality and population loss. Although the probability of being infected by HIV is assumed to decline significantly in the future (particularly after 2010), the long-term
impact of the epidemic remains dire. Over the current decade, the number of excess deaths because of AIDS among the 53 most affected countries is estimated at 46 million, and that figure is projected to
ascend to 278 million by 2050.

Despite the devastating impact of the HIV/AIDS epidemic, the populations of the affected
countries are generally expected to be larger by mid-century than today, mainly because most of them maintain high to moderate fertility levels. However, for the seven most affected countries in Southern
Africa, where current HIV prevalence is above 20 per cent, the population is projected to increase only slightly, from 74 million in 2000 to 78 million in 2050, and outright reductions in populations are
projected for Botswana, Lesotho, South Africa and Swaziland. E.g., in Botswana the population in 2050 is estimated to be 1.4 million, 20 per cent lower than the population in 2000 and 63 percent lower
than the population of 2050 projected without AIDS. The life expectancy in Botswana is estimated to be 39.7 in 2000-2005 with AIDS and 68.1 years without AIDS.

What responsibility would be incumbent on the Church given the projections presented above? Focusing on the
serious AIDS impact alone, the Church cannot take an ostrich-like approach. Two approaches may be proposed here:

For those already infected with AIDS, the Church should ensure that they be treated with respect, and their
dignity as human beings be respected. In India and in the Democratic Republic of Congo — areas where I have worked, healthcare professionals sometimes refuse to treat AIDS patients. Families have
ostracised relatives known to be HIV positive, exacerbating the tendency to hide the facts and making timely care difficult. Further, in developing countries, the availability of retro-viral drugs at low
cost should be promoted, as well as appropriate follow-up for infected persons using the drugs. Church health personnel and networks clearly have an important role to play, and appropriate training should
be provided.

For those at risk but not infected with AIDS, timely education regarding AIDS and
various routes of infection should be made available. Prevention methods should not be restricted to the “safe-sex” approach in vogue in much of the Western aid literature. Hygienic standards should be
insisted on in clinics, blood donations and the use of sterilised needles for injections. It should also be made abundantly clear that Church norms regarding pre-marital sex and fidelity to one’s spouse
present the surest way to avoid infection. Where one of the spouses is infected, a sensitive pastoral guidance based on sound morality should be offered.

Jesuit AIDS Project in Burundi Continues Despite War
HIV-AIDS is the Biggest Threat to Africa Since the Slave Trade

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